2.Statistical Clinical Survey of Poisoning (Hazard) from Agricultural Chemicals
Takeshi Sugaya ; Toshikazu Wakatsuki
Journal of the Japanese Association of Rural Medicine 1984;33(2):81-88
Clinical cases of poisoning (hazard) from agricultural chemicals frequency have been reported since 1967.
The clinical cases of poisoning (hazard) decreased not always yearly. It seems that there were periods of organophosphorus (Parathion, EPN), of organic mercury and organochlorine (DDT, BHC, Endrin) in the poisoning (hazard) and environment pollution from agricultural chemicals. But, it is now a period of herbicide (Paraquat).
1) The clinical cases surveyed during this three years period totaled 326 cases, including 185 males and 141 females.
2) By age, the highest incidence was shared by people in their 50's.
3) By month, the incidence is the highest in July.
4) Nicotine sulfate and organophosphorus (Sumithion) shares the highest pacentage during pesticide spraying. But Paraquat (herbicide) shares the most highest percentage in suicides and attempted suicides. There were twenty-nine casces by paraquat among forty-one death cases during thrre years period.
5) According to the types of diseases, acute poisoning shared the highest portion with 58%, which is followed by dermatitis with 40%.
3.Residue of Organochlorine Pesticide and PCB in Humans
Takeshi Sugaya ; Kazuhiro Watanabe ; Shiro Sasaki
Journal of the Japanese Association of Rural Medicine 1984;33(2):140-146
Organochlorine insecticides (BHC, DDT, etc) have been used in massive quatities in Japan. But in 1971, the goverment put a ban on their use as insecticides. We continued the residue analyses of organochlorine insecticide in human bodies from 1971 to 1982. This paper deals with the results of our residue analyses from 1980-1982. In paralel, We have also continued to analyze the residue of PCB.
(1) A total of 264 specimens have been analyzed for human mother milk, the adipose tissue, the liver, the kidney and the spleen.
(2) β-BHC and pp'-DDE were detected from all of these specimens.
(3) Over a span 12 years, the decrease of total-DDT was smaller than that of β-BHC.
(4) In the adipose tissue, there were no signs of a decrease in total DDT.
(5) PCB was detected from all specimens of mother milk, the adipose tissue and the liver.
It is conceivable that the pollution of human bodies by BHC, DDT. PCB, and other chemicals will last for a long time.
There is a need to keep constant surveillance over the tendency of these chemicals in the environment and human bodies.
4.Statistical Analyses of Clinical Cases of Skin Lesions from Agricultural Chemicals in Japanese Farmers, 1982-1989.
Zhi-yu WANG ; Toshio MATSUSHITA ; Kohji AOYAMA ; Konomi OBAMA ; Takeshi SUGAYA ; Shohsui MATSUSHIMA ; Toshikazu WAKATSUKI
Journal of the Japanese Association of Rural Medicine 1991;40(4):909-916
Statistical analyses were made on a total of 242 clinical cases of skin disordersfrom agricultural chemicals in Japanese farmers, using data recorded by physicians on standard forms in 41 hospitals and other medical institutions during the 1982-89 period. The majority of the cases were acute dermatitis (72.3%), followed by chronic dermatitis (19.0%), chemical burns (7.4%) and photosensitive dermatitis (2.1%). Organophosporus insecticides were the most frequent inducer of occupational skin lesions (24.8%), followed by sulfur fungicides (20.7%), polyhaloalkylthio-fungicides (16.1%), and soil disinfectants (7.9%). Main factors contributing to the onset of skin lesions were insufficient clothing on the part of users (46.7%), carelessness (21.9%), unsuitable weather (strong wind) (9.9%) and so forth. Epidemiological features such as sex, age, season, complications, affected sites and prognoses were also analyzed and discussed.
5.A Study of Health Problems and Different Types of Agricultural Production
Takeshi Sugaya ; Shigeki Hayashi ; Masato Hayashi ; Tomio Matsuoka ; Shunji Okubo ; Akira Kotanagi
Journal of the Japanese Association of Rural Medicine 1983;32(2):65-71
A study was made to elucidate growing health problems confronting women in rural communities today amidst drastic changes in agriculture.
From the standpoint of production structure, the area covered by our survey was divided into single-crop (paddy-rice), paddy-rice and fruits (apple), paddy-rice and water melon, and fishing village districts. In each of these districts, we conducted a survey by the use of a questionnaire and a health examination.
1, About 45 to 70 % of women engaged in farming complained that they could not take enough time to sleep. Especially in the paddy-rice and water melon producing district, the percentage was high.
2. Female farmers who complained of pains in the legs and the lower part of the back accounted for 40-60 % of the total. The rates were high in the rice producing district, and the paddy-rice and water melon producing district. This is probably due to the nature of farm work. However, the cause of the complaints was not always clear in the paddy-rice district.
3. Depending on the working postures (work on the stepladden in the orchard, work on hillsides, work in the supine position, etc.), the ailing region they complained about differed.
4. Those women who take care of supplementary work when machines are employed said that they feel they are subordinate to mechnization.
5. When pesticides are used, 10-20 % of the subjects showed toxic symptoms. In the paddy-rice and apple growing district, high ratios were recorded.
6. Of the total, 52.7 % were found negative in the mass health screening. The rate was the highest in the paddy-rice and water melon producing district.
7. The obesity rate rose in proportion to the rise in age.
8. The incidence of hypertension (WHO criteria) was the lowest in the fishing community, followed by the paddy-rice and apple district, and the rice producing district in that order.
9. As regards the hemoglobin level, those who showed less than 12.0 g/dl accounted for 11 to 32%. The level was lowest in the paddy-rice and apple producing district, followed by the paddy-rice district and the fishing village. There were few who need medical treatment immediately.
10. Abnormality of liver function was found among some 5 % of the examined. Serum cholesterol levels were lower in the paddy-rice district than in the other districts.
6.Results of mass screening for breast cancer in rural districts of Akita prefecture.
Akira Suzuki ; Hironori Kato ; Susumu Kishibe ; Yuji Ono ; Cho Morooka ; Kazuhiko Takano ; Tadanobu Watanabe ; Tomio Matsuoka ; Toshio Ikeda ; Takeshi Sugaya
Journal of the Japanese Association of Rural Medicine 1985;34(4):803-807
This present study was conducted among the nine centers of Akita prefectural Welfare Federation of Agricultural Cooperatives. This applied to women over 30 years of age, and carried out following to the standard method of the Japan Cancer Society.
The total of women examined by the first screening from April 1983 to January 1985 amounted to 15903, of which the number of women over 60 years of age was only 7 per cent of the total. According to the type of screening, the number of women slightly more in the center screening than in the local screening. However, in both types of screening, the number of women examined by the combination method, for example, anemia or uteric cancer, was much higher than that of the mass screening for breast cancer alone.
The second screening rates indicaded a marked difference of 0.4 to 21.7 per cent depending on the location of the center. The over-all average for the second screening was 3.8 per cent. As a result of the second screening, breast cancers were detected in 12 cases (0.07%). The breast cancer detection rate increased with age. It is notable that the breast cancer detection rate for women over 60 years of age was 5 times higher than for women over 40 years of age. Among other diseases detected in the second screening were mastpathy (233 cases), fibroadenoma (15 cases), mastitis (40 cases) and others.
As far the stage distribution and screening history for detected breast cancers, 60 per cent of all cancer cases were diagnosed as stage I, and 70 per cent were the initial screening. Seven out of 12 cases were aware the breast lump themselves before the first screening. From this point of view, it was suggested that every women should be educated in order to perform selfexamination.
7.Primary health care in a rural district, Akita prefecture.
Takeshi SUGAYA ; Masato HAYAHI ; Shunji OKUBO ; Kimio SAITO ; Kenichi HOSOYA ; Tomio MATSUOKA ; Akira KOTANAGI ; Takashi SATO ; Kenkichi TAKISAWA ; Seiko ISHINARI
Journal of the Japanese Association of Rural Medicine 1987;36(2):79-84
Investigation was made into the health care conditions in a rural district in Akita Prefecture. Topographically, the district is divided into two parts-one characterized by mountain and the other by flat terrain.
1. In remote, depopulated villages, per capita cost of public health is on the increase.
2. The number of health personell, particularly public health nurses, is not enough to carry on various health programs.
3. With the prospect of greater numbers of the aged in society, there is an urgent need for increased medical services along with the consolidation of primary health care. In order to meet the need, it is necessary to establish a regional community health system comprised of a hospital as a nucleus and neighborhood medical instituions such as clinics and health centers.
8.Statistical study of clinical cases of skin disorder from agricultural chemicals in Japanese farmers, 1972-1981.
Toshio MATSUSHITA ; Kohji AOYAMA ; Zhi-yu WANG ; Qing LI ; Konomi OBAMA ; Takeshi SUGAYA ; Shohsui MATSUSHIMA ; Toshikazu WAKATSUKI
Journal of the Japanese Association of Rural Medicine 1990;39(2):64-70
A total of 630 clinical cases of occupational skin disorder from agricultural chemicals werestatistically analyzed in Japanese farmers who were recorded by physicians on a standard form from41 hospitals and other medical institutions during the 1972-81 period. The majority of the cases wereacute dermatitis (66.7%). This was followed by chronic dermatitis (24.3%), chemical burns (8.4%) andphotosensitive dermatitis (2.2%). By type to chemicals, the number one skin hazard was sulfurfungicides (32.2%), followed by organophosphorus insecticides (28.6%), polyhaloalkylthio-fungicides (11.4%), and copper fungicides (7.1%). Factors contributing to the onset of any disorder of the skinwere mainly defenseless on the part of users (41.3%), carelessness (20.2%), poor health condition(14.6%), and so forth. Other epidemiological features by sex, age, season, complications, sites of skindisorder, prognosis, etc. were also analyzed and discussed.
9.Studies on Low Back Pain Caused by Agricultural Work in Flat Villages of South District in Akita Prefecture and by Work of Fisherman in a Fishing Village in Iwate Prefecture
Takeshi Sugaya ; Shigeki Hayashi ; Masato Hayashi ; Tomio Matsuoka ; Atsuro Yoshizumi ; Shinji Okubo ; Hiroshi Kitahara ; Kazuhiro Watanabe ; Yukio Ito ; Akira Kotanagi
Journal of the Japanese Association of Rural Medicine 1983;32(4):817-826
As regards to low back pain of agricultural worker, there are many problems still as to a syndrom of “Nofusho” in rural medicine, a disease in ocupational medicine and clinic of orthopedic.
Agricultural worker who complained of low back pain varies with their country and farm products, and it tend to increase with adding to their age. Further, the female rate of low back pain showed slightly high tendency than the made rate, 8.5-12.5 % of male, 6.5-13.4 % of female always complained of low back pain.
According to the findings of roentogenographic examination of back bone, the deformed vertebrae was found clearly, especially, low back pain caused by a trauma of soft tissue and iscogenic pain showed in farmers. Therefor, it is necessary to be improved working posture and condition.
In comparrison with non-farmer, it is located in order of truck drivers. bus drivers and repairmen.
10.Optimal Maintenance Strategy for First-Line Oxaliplatin-Containing Therapy with or without Bevacizumab in Patients with Metastatic Colorectal Cancer: A Meta-Analysis
Toshikazu MORIWAKI ; Masahiko GOSHO ; Akinori SUGAYA ; Takeshi YAMADA ; Yoshiyuki YAMAMOTO ; Ichinosuke HYODO
Cancer Research and Treatment 2021;53(3):703-713
Purpose:
Maintenance therapy after oxaliplatin withdrawal is useful in patients with metastatic colorectal cancer (mCRC). This study aimed to investigate the timing of discontinuation or reintroduction of oxaliplatin and the optimal maintenance therapy regimen for survival.
Materials and Methods:
PubMed and conference abstracts were searched to select phase II and III trials of first-line oxaliplatin-containing therapy with or without bevacizumab using maintenance therapy for mCRC. Correlations of median overall survival (OS) with induction therapy regimens, induction therapy duration, maintenance therapy regimens (fluoropyrimidine plus bevacizumab [FP+Bev], FP/Bev alone, and no treatment), and oxaliplatin reintroduction were investigated using correlation and weighted multivariate regression analyses.
Results:
Twenty-two treatment arms were analyzed, including 2,581 patients. The maintenance therapy regimen FP+Bev showed the strongest correlation with a prolonged OS (Spearman’s partial correlation coefficient=0.42), and the other three variables correlated weakly with the OS. The maintenance therapy regimen significantly interacted with the induction chemotherapy duration (p=0.019). The predicted OS for FP+Bev crossed the lines of FP/Bev alone at 18 weeks of induction therapy, and of no treatment at 23 weeks. The corresponding OS at 12 and 27 weeks of induction therapies were 28.6 and 24.2 months for FP+Bev, 25.9 and 28.8 months for FP/Bev alone, and 20.5 and 27.5 months for no treatment.
Conclusion
The optimal maintenance therapy regimen for the OS is a continuous induction therapy as long as possible followed by FP/Bev alone and switching to FP+Bev within approximately 4 months if induction therapy is discontinued.